In Person Events
All Provider Education
A Day with Medicare
April 25, 2017 – Saint Charles, MO – 8:30 am – 4:30 pm CT
July 11, 2017 – Salina, KS – 8:30 am – 4:30 pm CT
July 13, 2017 – Des Moines, IA – 8:30 am – 4:30 pm CT
Don’t Miss This FREE Full Day Educational Opportunity!WPS GHA is pleased to announce a full day educational event designed for providers and suppliers of all types. The multi-breakout sessions will allow providers to pick topics they are interested in. This exciting program includes both Part A and Part B topics to gain insight into the cause for errors and how to avoid them in the future, including:
- General session
- 12 breakout sessions
- Question and answer session
- More!
To view the brochure click on the link provided, or use the following URL: https://wpsghalearningcenter.com/files/2017ADWMBrochure.pdf
Don’t Get Wrapped Up in Overlapping Claims (Part A)
04/11/2017 – Omaha, NE – 8:30 AM – 4:00 PM CT
06/14/2017 – Iowa City, IA – 8:30 AM – 4:00 PM CT
08/15/2017 – Topeka, KS – 8:30 AM – 4:00 PM CT
Overlapping claims continue to be a top claim rejection for providers. Medicare often receives multiple claims for the same beneficiary with the same or similar dates of service. An overlap occurs when the date of service or billing period of one claim seems to conflict with the date on another claim, indicating that one of the claims may be incorrect. Often, overlapping claims can be prevented by knowing how to properly submit claims in certain situations.During this full day seminar, WPS GHA will go over the most common reasons for overlapping claims and steps providers can take in an overlapping claim situation. Some of the topics to be covered include:
- Billing during a leave of absence (LOA)/interrupted stay
- What “hospital bundling” includes
- How to determine the proper patient status to use on your claim
- Main cause of SNF overlaps (aside from Consolidated Billing)
- 3/1 day payment window
- End Stage Renal Disease (ESRD) Consolidated Billing
- Home Health Consolidated Billing
- What Place of Service (POS) Part B providers should use
- Steps you can take to resolve overlapping claim issues with another provider
AppealsAppeals – Importance of Getting it to the Right Place Timely
05/16/2017 – Springfield, MO – 9:00 am – 12:00 pm CT
Due to confusion relating to the appeal process, WPS GHA has seen an increase in the number of appeal decision dismissals and duplicate appeals. Submitting appeals to the right place at the right time requires knowledge of the different levels in the appeals process, an understanding of the timeframes involved for each level and the role of the different Medicare contractors. During this seminar, we will review the levels in the appeal process, discuss ways to avoid dismissal decisions and duplicate requests.
Claims
Actions on Claims
04/13/2017 - Kansas City, MO – 8:30 am – 11:30 am CT
05/04/2017 - Coralville, IA – 9:00 am – 12:00 pm CT
05/11/2017 - Wichita, KS – 8:30 am – 11:30 am CT
06/15/2017 - Grand Island, NE – 8:30 am – 11:30 am CT
Tentative Schedule
- November 2017 Ankeny, IA
Ever wonder what to do when a Medicare claim cannot process? How about why a claim denies, what is next? This course will answer those questions by covering the following:
- Action on claims that are not adjudicated
- Claim reopening process
- Claim appeal process
- Appeal dismissals and duplicate requests
- And more
To protect the identity of our beneficiaries and providers, we ask that you please do not bring any claim specific protected health information (PHI) or personally identifiable information (PII) to this class.Due to system restrictions and confidentiality, the instructor for this class will not be able to look at or address claim specific errors. Please do not bring any claim specific protected health information (PHI) or personally identifiable information (PII) to this class.Focus On: Avoiding Medicare Secondary Payer (MSP) Denials
04/11/2017 - Kansas City, MO – 1:00 pm – 4:00 pm CT
05/09/2017 - Wichita, KS – 1:00 pm – 4:00 pm CT
06/13/2017 - Grand Island, NE – 1:00 pm – 4:00 pm CT
Tentative Schedule
- November 2017 Ankeny, IA
Is Medicare primary or secondary? Determining the correct payer is very important, but it’s only part of the process. Different situations have unique billing requirements. In this course, we will discuss the most common MSP processing errors and discover the best ways to avoid them. This is not an MSP overview- the focus will be on preventing unnecessary denials, overpayments and adjustments. Our agenda will include:
- Examine the most common MSP errors
- Understand what the denials mean
- Explore ways to correct and prevent them
Focus On: Preventing UB-04 Denials
04/12/2017 - Kansas City, MO – 8:30 am – 4:00 pm CT
05/10/2017 - Wichita, KS – 8:30 am – 4:00 pm CT
06/14/2017 - Grand Island, NE – 8:30 am – 4:00 pm CT
Tentative Schedule
- November 2017 Ankeny, IA
Do you dread looking at your Medicare remittance advice because of the amount of time you know you will have to spend researching, rebilling, adjusting or appealing denials? Join us as we analyze the most common billing errors made by Part A providers in your area, identify resolutions and discuss ways to prevent them from happening to you. Topics will include:
- Review denial data
- Examine reason code narratives
- Share best practices and claims processing tips
Focus On: Claim Determinations from Other Contractors
04/13/2017 – Kansas City, MO – 1:00 pm – 4:00 pm CT
05/11/2017 - Wichita, KS – 1:00 pm – 4:00 pm CT
06/15/2017 - Grand Island, NE – 1:00 pm – 4:00 pm CT
Tentative Schedule
- November 2017 Ankeny, IA
CMS employs a variety of contractors to process and review claims according to Medicare rules and regulations. In this session, we will examine some of the denials being assessed by these contractors, understand WPS GHA’s involvement in the process and explore ways to prevent the errors from happening in the future. The agenda will include:
- Discuss the role of other contractors
- View data showing reasons for denial
- Understand WPS GHA’s role
The World of a Claim – Where does the claim start and how does it end?
04/11/2017 - Kansas City, MO – 8:30 am – 11:30 am CT
05/09/2017 - Wichita, KS – 8:30 am – 11:30 am CT
06/13/2017 - Grand Island, NE – 8:30 am – 11:30 am CT
Tentative Schedule
- November 2017 Ankeny, IA
This seminar will focus on a claims journey from provider responsibilities before submitting a claim to Medicare, what happens during processing, and the completion of a processed claim. The seminar will cover:
- Information to get from the patient
- Determining who to bill
- A high-level documentation overview
- An overview of Medicare claim processing
- An overview of Skilled Nursing Facility Consolidated Billing
- During this course, we will not cover specific denials as the presenter does not have access to the Medicare claims processing systems.
Consolidated BillingAn Interactive Day of Skilled Nursing Facility (SNF) Consolidated Billing
04/12/2017 – Omaha, NE – 8:30 AM – 4:00 PM CT
06/15/2017 – Iowa City, IA – 8:30 AM – 4:00 PM CT
08/16/2017 – Topeka, KS – 8:30 AM – 4:00 PM CT
Do you want to become a “pro” at Skilled Nursing Facility (SNF) Consolidated Billing? Become the go-to person in your office for related questions? Then you’ll want to join us for this full day, interactive seminar! This will be an INTENSIVE day of hands-on training and implementing strategies that will give you the tools you need to be the subject matter expert in your office.You will learn the whys, ifs, ands, and buts when it comes to SNF Consolidated Billing. Then, working in groups, you’ll put what you have learned into action. Using laptops, each group will determine who the responsible payer would be in a variety of situations.Take this opportunity to network with providers you work with on a regular basis. Call them now and ask them to attend! This is your chance to sit down and formulate arrangements and what the terms and conditions will be.
Documentation
Does Your Medicare Documentation Measure Up?
04/11/2017 - Kansas City, MO – 8:30 am – 4:00 am CT
05/09/2017 - Wichita, KS – 8:30 am – 4:00 am CTTentative Schedule
- June 2017 Grand Island, NE
- November 2017 Ankeny, IA
Knock, knock. Who’s there? A Medicare medical review contractor…Has your documentation ever been subject to a Medicare edit or audit? Do you know where to find the documentation requirements for the service you are providing? Do you know who the Medicare review contractors are and what their expectations are of your facility?Join WPS GHA for a live seminar in which we will
- Identify and discuss Medicare medical review contractors
- Identify Medicare documentation guidelines
- Discuss the dos’ and don’ts of Medicare documentation
- Review actual documentation that was considered in coverage determinations
Due to system restrictions and confidentiality, the instructor for this class will not be able to look at or address claim specific errors. Please do not bring any claim specific protected health information (PHI) or personally identifiable information (PII) to this class.
Medicare Part A Denials – Building Strong Facility Documentation
04/12/2017 - Kansas City, MO – 8:30 am – 4:00 am CT
05/10/2017 - Wichita, KS – 8:30 am – 4:00 am CTTentative Schedule
- June 2017 Grand Island, NE
- November 2017 Ankeny, IA
Documentation is the key to accurate Medicare payment for services provided. In this live session, we will review the most common Part A claim review denials as well as practical documentation strategies to avoid documentation issues in your facility. Understanding the issues and learning how to avoid them is the key to safeguarding appropriate payment to your facility. In this session, we will also use actual documentation that was considered in coverage determinations as review exercises.Due to system restrictions and confidentiality, the instructor for this class will not be able to look at or address claim specific errors. Please do not bring any claim specific protected health information (PHI) or personally identifiable information (PII) to this class.
Evaluation and Management
Evaluation and Management: Inpatient Services
03/22/2017 – Cedar Rapids, IA – 9:00 am – 12:00 pm CT
This seminar is intended for our J5 Part A/B providers billing on a UB-04/CMS-1500 or the electronic equivalent.Medicare denies numerous evaluation and management (E/M) inpatient services when the documentation does not meet the guidelines. Want to reduce the denials you receive? Want to get your claims paid the first time? We will discuss the Medicare rules and common reasons for denials. Join us in a presentation on E/M services provided in an inpatient setting.We will discuss the following:
- Initial inpatient
- Subsequent inpatient
- Discharge management
- Critical Care
- Shared/Split services
- Teaching physician documentation
We will provide and discuss documentation examples and exercises. This presentation will assist you in reducing the Comprehensive Error Rate Testing (CERT) and other medical review denials.
Evaluation and Management: Post Acute Services
03/22/2017 – Cedar Rapids, IA – 1:00 pm – 4:00 pm CT
Medicare denials for services provided after a patient has left a hospital setting continue to cause problems. Want to understand the denial? Want to know more information on how to reduce your specific denials? This presentation will discuss the following:
- Transitional Care Management
- Nursing Facility
- Home Health Certification/Recertification
- Care Plan Oversight
- Ordering Equipment
- Documentation exercises
We will provide and discuss documentation examples and exercises. This presentation will assist you in reducing the Comprehensive Error Rate Testing (CERT) and other medical review denials.
Evaluation and Management: Office Services
03/23/2017 – Cedar Rapids, IA – 9:00 am – 12:00 pm CT
Every wonder why Medicare denies or recoups your evaluation and management (E/M) services provided in an office setting? This presentation will provide you with information on the requirements for billing office E/M services. We will include information on the following:
- Documentation guidelines for Office E/M
- Incident to and Shared/Split guidelines
- Correct billing when also performing other services
- Ordering durable medical equipment
- Welcome to Medicare visit
- Annual Wellness Visit
- Chronic Care Management
- Advanced Care Planning
We will provide and discuss documentation examples and exercises. This presentation will assist you in reducing the Comprehensive Error Rate Testing (CERT) and other medical review denials.
Evaluation and Management: Outpatient Services
03/23/2017 – Cedar Rapids, IA – 1:00 pm – 4:00 pm CT
Want to reduce denials and increase your understanding of Medicare’s guidelines for evaluation and management (E/M) services provided in an outpatient setting? This is the course for you. We will provide the rules, regulations, and billing instructions for the following:
- Provider-based Clinic E/M Services
- Emergency Department
- Observation Unit or Bed
- Multiple Services and/or Providers
- Procedures and E/M
- Shared/Split services
We will provide and discuss documentation examples and exercises. This presentation will assist you in reducing the Comprehensive Error Rate Testing (CERT) and other medical review denials.
Medicare Secondary PayerUnderstanding the Medicare Secondary Payer (MSP) Billing Process
05/16/2017 – Springfield, MO – 1:00 pm – 4:00 pm CT
Are you spending a lot of time trying to get your MSP claims to process correctly? Do you understand what you need to update the beneficiary information on the Common Working File (CWF)? During this seminar we will review the different MSP categories, discuss common MSP situations and review scenarios. We will also clarify how to submit claims when secondary payers are involved and cover the steps needed to update the beneficiary information on CWF.
Teleconferences
Advance Beneficiary Notice of Noncoverage (ABN)
Advance Beneficiary Notice of Noncoverage (ABN) Ask-the-Contractor Teleconference (ACT)
04/05/2017 – 9:00 AM – 10:30 AM CT
Do you use the form CMS-R-131? Do you have questions on the form?
Attend the open question and answer session and have your questions answered. WPS GHA staff will make opening comments, answer pre-submitted questions, and if time allows an open question and answer session. The session is scheduled for 90 minutes and if the open question and answer session does not last the entire time, the call will end early.
Due to system restrictions and confidentiality, WPS GHA staff will not be able to look at or address claim specific errors.
Ambulance
Ambulance and Hospice Billing
03/22/2017 – 9:00 AM – 10:30 AM CT
Do you have problems receiving payment for transports for patients that have elected hospice? In this teleconference, we will provide billing clarification on how to properly bill an ambulance run before, during, and after the patient is enrolled in hospice. Join us and get the information you need.
New to Medicare
New to Medicare – Reimbursement Methodologies
04/04/2017 – 9:00 AM – 10:30 AM CT
The fourth session in a series for those working with Medicare for less than 1 year or with questions on the basics of the Medicare program. This teleconference will address information needed by anyone who is beginning to learn the Medicare program with a focus on reimbursement. The agenda will include:
- What are the payment methodologies?
- Time frames for claims submitted under each method
- How the methodologies affect each other
- And more
New to Medicare – The Claim Teleconference
05/02/2017 – 9:00 AM – 10:30 AM CT
The fifth session in a series for those working with Medicare for less than 1 year or with questions on the basics of the Medicare program. This teleconference will address information needed by anyone who is beginning to learn the Medicare program. The agenda will include:
- Electronic vs paper submission
- Overview of system edits and audits
- Correcting claims
- Appeals
- And more
New to Medicare – Find What You Need Teleconference
06/06/2017 – 9:00 AM – 10:30 AM CT
The sixth session in a series for those working with Medicare for less than 1 year or with questions on the basics of the Medicare program. This teleconference will address information needed by anyone who is beginning to learn the Medicare program with a focus on resources. The agenda will include:
- The CMS website
- The WPS GHA Portal
- Other important websites
- And more
Webinars
Observation
Observation Documentation for Facilities and Physicians
03/29/2017 – 10:00 AM – 11:30 AM
WPS GHA is hosting a webinar on Observation Documentation for Facilities and Physicians intended for our J5 and J8 Part A and Part B providers billing on a CMS-1500, UB-04 or their electronic equivalents.
This program will cover the basic coverage criteria for observation services but will focus on observation documentation requirements including a review of sanitized documentation samples of observation services.
Physician Observation Care
03/15/2017 – 10:00 AM – 11:30 AM
The program will discuss the billing and documentation requirements for Observation services. Billing requirements include who can bill observation, why the hospital documentation makes a difference in physician billing, how to bill for services provided by someone other than the admitting physician, and documentation requirements.
Our agenda will include:
- Discussion of the restriction on who can bill observation services
- The importance of the hospital documentation
- Subsequent observation care services
- Observation discharge management
- Comprehensive Error Rate Testing (CERT) errors